E-Book, Englisch, 456 Seiten, ePub
Carlson / Van Abel / Archibald Otolaryngology--Head and Neck Surgery
1. Auflage 2014
ISBN: 978-1-63853-032-9
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark
Rapid Clinical and Board Review
E-Book, Englisch, 456 Seiten, ePub
ISBN: 978-1-63853-032-9
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark
This well-organized text for rapid clinical and board review contains high-yield facts using a question and answer format that covers all subspecialty topics in otolaryngology. It combines clinically relevant facts with hard-to-remember, commonly tested details and presents them in an easy-to-follow layout that allows clinicians to quickly review large amounts of information.
Key Features:
- More than 9,000 high-yield questions and answers, half provided in the book and the other half online
- Portable for quick reference during downtimes such as before morning rounds, in between OR cases or while traveling
- Clinical pearls on patient evaluation and management
This review book is a must-have for residents preparing for in-service exams or initial board certification exams as well as seasoned clinicians studying for their MOC Part III re-certification exams.
This print book includes complimentary access to a digital copy on https://medone.thieme.com.
Publisher's Note: Products purchased from Third Party sellers are not guaranteed by the publisher for quality, authenticity, or access to any online entitlements included with the product.
Autoren/Hrsg.
Fachgebiete
Weitere Infos & Material
Chapter 1: Pediatric Otolaryngology–Head and Neck Surgery
Chapter 2: Pediatric Malignancies
Chapter 3: Rhinology, Allergy, and Immunology
Chapter 4: General Otolaryngology
Chapter 5: Laryngology
Chapter 6: Otology, Neurotology, and Lateral Skull Base Surgery
Chapter 7: Head and Neck Surgical Oncology
Chapter 8: Cutaneous Malignancies
Chapter 9: Facial Plastic and Reconstructive Surgery
Chapter 10: Facial Trauma
Chapter 11: Salivary Gland Disorders
Chapter 12: Endocrine Disorders
Chapter 13: Odontogenic Disorders
2 Pediatric Malignancies
Rhabdomyosarcomas
| 1 | Second to accidents, what is the most common cause of death in children between 1 and 14 years of age? | Malignancy |
| 2 | What is the most common sarcoma of childhood? | Rhabdomyosarcoma. Up to 35% are found in the head and neck. |
| 3 | Which cell type gives rise to rhabdomyosarcoma, and what major histologic variants are described? | Primitive skeletal muscle cells (small, round blue cell tumor of childhood): embryonal, botryoid, alveolar, undifferentiated. Some include anaplastic. Embryonal and alveolar are the most common types, and embryonal type carries the best prognosis. |
| 4 | Where does pediatric head and neck rhabdomyosarcoma most commonly occur? | (50%): Paranasal sinuses, nasopharynx, nasal cavity, middle ear, mastoid, infratemporal fossa (5-year survival: 49%; considered high risk) (25%) (5-year survival: 84%) (25%): Scalp, parotid, oral cavity, pharynx, thyroid, parathyroid, neck (5-year survival: 70%) |
| 5 | What are the common initial symptoms associated with head and neck pediatric rhabdomyosarcoma? | Symptoms are due to progressive mass effect, local swelling, neurologic sequelae, or tissue necrosis. Bone marrow involvement can manifest as hematologic concerns. |
| 6 | What are the most important negative prognostic factors associated with pediatric rhabdomyosarcoma? | Diagnosis during infancy or adolescence; metastatic disease at diagnosis; alveolar histology; disease identified in a parameningeal location (risk for intracranial spread), in the extremities, or in the retroperitoneum or trunk; recurrence or progression during therapy |
| 7 | What diagnostic techniques are required to evaluate the primary tumor in rhabdomyosarcoma? | Biopsy: Open biopsy is done to ensure adequate tissue unless the lesion is small and difficult to access, in which case, needle biopsy may be acceptable. Imaging: CT scan and magnetic resonance imaging (MRI) to evaluate extent of disease |
| 8 | What diagnostic techniques are required to evaluate locoregional and/or distant metastases in rhabdomyosarcoma? | Laboratory work (complete blood count [CBC], electrolytes, liver function, coagulation studies, renal function tests) Technetium-99 bone scan CT chest Positron emission tomography (PET)/CT scan Aspiration/biopsy of iliac bone marrow. Distant metastases are more commonly found in the brain, lung, bone, and bone marrow. |
| 9 | Which group is credited with increasing the survival rate for patients with rhabdomyosarcoma from 30 to 70% since the 1970s? | The Intergroup Rhabdomyosarcoma Study Committee (now the Soft Tissue Sarcoma Committee of the Children's Oncology Group) |
| 10 | What is the clinical grouping or surgical pathologic staging system commonly used for staging rhabdomyosarcoma? | ( Table 2.1) |
Table 2.1 Surgical-Histopathologic Clinical Grouping System for the Intergroup Rhabdomyosarcoma Study
| Stage | Description |
| Group I | Localized disease, completely resected |
| A | Confined to organ or muscle of origin |
| B | Invasion outside organ/muscle of origin; regional nodes not involved |
| Group II | Compromised or regional resection including |
| A | Grossly resected tumors with microscopic residual tumor |
| B | Regional disease, completely resected, in which nodes may be involved and/or tumor extends into an adjacent organ |
| C | Regional disease with involved nodes, grossly resected, but with evidence of microscopic residual |
| Group III | Incomplete resection or biopsy with gross residual disease |
| Group IV | Distant metastases, present at onset |
| Data from Crist WM, Garnsey L, Beltangady MS, et al. Prognosis in children with rhabdomyosarcoma: a report of the intergroup rhabdomyosarcoma studies I and II (Intergroup Rhabdomyosarcoma Committee). J Clin Oncol. 1990 Mar;8 (3):443–52. |
| 11 | What is the tumor, node, and metastases (TNM) staging system for rhabdomyosarcoma introduced by the Intergroup Rhabdomyosarcoma Study IV? | ( Table 2.2) |
Table 2.2 TNM staging system for rhabdomyosarcoma introduced by the Intergroup Rhabdomyosarcoma Study IV.
| Stage | Description |
| T1 | Confined to the anatomical site or origin |
| T2 | Extension beyond site of origin A: = 5 cm in diameter B: > 5 cm in diameter |
| N0 | No clinically involved lymph nodes |
| N1 | Clinically involved lymph nodes |
| NX | Clinical status unknown |
| M0 | No distant metastasis |
| M1 | Distant metastasis |
| MX | Distant metastasis unknown |
| Data from Neville HL, Andrassy RJ, Lobe TE, et al. Preoperative staging, prognostic factors, and outcome for extremity rhabdomyosarcoma: a preliminary report from the Intergroup Rhabdomyosarcoma Study IV (1991–1997). J Pediatr Surg. 2000 Feb;35(2):317–21. |
| 12 | Describe the staging system for rhabdomyosarcoma that combines the TNM and clinicopathologic groups to provide both prognostic and therapeutic recommendations. | Rhabdomyosarcoma prognostic stratification and standard treatment assignment (Prognosis, Event-Free Survival): Excellent (> 85%) Very good (75 to 85%) Good (50 to 70%) Poor (< 30%) This system allows for risk-directed therapy. |
| 13 | Describe the favorable and unfavorable locations for head and neck rhabdomyosarcoma. | Favorable: Orbit and eyelid Unfavorable: Parameningeal |
| 14 | True or False. In a patient with localized nonorbital, nonparameningeal head and neck embryonal rhabdomyosarcoma, if complete surgical excision can be achieved, radiation therapy may be avoided. | True. However, chemotherapy is recommended for all patients with rhabdomyosarcoma. |
| 15 | Is elective neck dissection for clinically negative necks recommended in patients with nonparameningeal rhabdomyosarcoma of the head and neck? | No |
| 16 | What are the most commonly used chemotherapeutic agents for treatment of rhabdomyosarcoma? | Vincristine, actinomycin D, cyclophosphamide |
| 17 | What are the most common late complications in patients treated for rhabdomyosarcoma of the head and neck? | Short stature, regional tissue hypoplasia, poor dentition, malformed teeth, impaired vision, decreased hearing, and learning disorders |
| 18 | What is the most common fibrous tumor of infancy? | Infantile myofibromatosis (solitary or multicentric; well-circumscribed, spindle-shaped cells, including fibroblasts and smooth muscle cells on histopathology) |
| 19 | What is the natural history of infantile myofibromatosis? | Most will involute by age 1 to 2 years. Visceral lesions causing functional impairment (e.g., pulmonary), may require surgical excision. For nonresectable, rapidly progressive, recurrent or symptomatic lesions, surgery, radiation therapy and chemotherapy should be considered. |
Other Sarcomas
| 20 | What tumor type is composed of a mixed group of mesenchymal malignancies that are generally defined as either soft tissue (80%) or bony/cartilaginous (20%) tissue? | Sarcomas. These tumors can arise from muscle, nerve, fat, vessel, fibrous tissue, bone, or... |
